06/11/2023, 16:24 An organizing, integrative review

An organizing,
integrative review
A growing body of research suggests
that disrupted sleep is a robust risk and
maintenance factor for a range of
psychiatric conditions. One
explanator…
7 min. read

Fecal microbiota transplantation (FMT) has

been reported with the treatment potential for
irritable bowel syndrome (IBS). However, the
knowledge of its effect on extraintestinal
symptoms of IBS is limited. This study aimed to
evaluate the efficacy of the improved
methodology of FMT, washed microbiota
transplantation (WMT), on sleep disturbances,
and psychological and gastrointestinal
symptoms among patients with IBS.

This was a prospective observational study

involving patients with IBS who underwent
WMT. The Pittsburgh Sleep Quality Index
(PSQI) was used to assess sleep quality. The
Gastrointestinal Symptom Rating Scale (GSRS)
and IBS Severity Scoring System (IBS-SSS)
https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 1/10
06/11/2023, 16:24 An organizing, integrative review

were used to evaluate gastrointestinal

symptoms and IBS severity, respectively. The
Self-rating Depression Scale (SDS) and Self-
rating Anxiety Scale (SAS) were used to
evaluate depression and anxiety, respectively.
All the symptoms were evaluated at baseline
and one month after WMT. A multiple logistic
regression model was used to determine the
predictive factors of sleep improvement one
month after WMT.

Seventy-three patients with IBS were included

in the study. Sleep quality (Z = −4.211,
P < 0.001), anxiety (Z = −4.775, P < 0.001),
depression (Z = −4.610, P < 0.001),
gastrointestinal symptoms (Z = −5.364,
P < 0.001), and IBS severity (Z = −6.468,
P < 0.001) significantly improved one month
after WMT in all patients. The scores of the five
components of PSQI including subjective sleep
quality, sleep latency, sleep duration, habitual
sleep efficiency, and sleep disturbances
decreased in 52 patients with poor sleep quality
(all P < 0.05). Baseline sleep duration scores
were identified as an independent predictive
factor of sleep improvement one month after
WMT in patients with poor sleep quality (OR
2.180 [95% CI = 1.017–4.673]; P = 0.045).
Patients that experienced sleep improvement
demonstrated greater alleviation in depression
(Z = −1.990, P = 0.047) and IBS severity
(Z = −2.486, P = 0.013) compared with patients
without sleep improvement.
https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 2/10
06/11/2023, 16:24 An organizing, integrative review

This study suggested that WMT might be a

promising therapy for patients with IBS,
especially those with comorbid sleep and
psychological disorders.

Consumer sleep trackers issue daily guidance

on ‘readiness’ without clear empirical basis. We
investigated how self-rated mood, motivation,
and sleepiness (MMS) levels are affected by
daily fluctuations in sleep duration, timing, and
efficiency and overall sleep regularity. We also
determined how temporally specific these
associations are.

119 healthy university students (64 female,

mean age = 22.54 ± 1.74 years) wore a wearable
sleep tracker and undertook twice-daily
smartphone-delivered ecological momentary
assessment of mood, motivation, and sleepiness
at post-wake and pre-bedtime timings for 2–6
weeks. Naps and their duration were reported
daily. Nocturnal sleep on 2471 nights were
examined using multilevel models to uncover
within-subject and between-subject
associations between sleep duration, timing,
efficiency, and nap duration on following day
MMS ratings. Time-lagged analyses examined
the temporal specificity of these associations.
Linear regression models investigated
associations between MMS ratings and sleep
variability, controlling for sleep duration.

https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 3/10
06/11/2023, 16:24 An organizing, integrative review

Nocturnal sleep durations were short

(6.03 ± 0.71 h), and bedtimes were late
(1:42AM ± 1:05). Within-subjects, nocturnal
sleep longer than a person's average was
associated with better mood, higher motivation,
and lower sleepiness after waking. Effects of
such longer sleep duration lingered for mood
and sleepiness till the pre-bedtime window (all
Ps < .005) but did not extend to the next day.
Between-subjects, higher intraindividual sleep
variability, but not sleep duration, was
associated with poorer mood and lower
motivation after waking. Longer average sleep
duration was associated with less sleepiness
after waking and lower motivation pre-bedtime
(all Ps < .05). Longer naps reduced post-nap
sleepiness and improved mood. Controlling for
nocturnal sleep duration, longer naps also
associated with lower post-waking sleepiness
on the following day.

Positive connections between nocturnal sleep

and nap duration with MMS are temporally
circumscribed, lending credence to the
construction of sleep-based, daily ‘readiness’
scores. Higher sleep duration variability lowers
an individual's post waking mood and
motivation.

ClinicalTrials.gov NCT04880629.

Obstructive Sleep Apnoea (OSA) is associated

with high rates of depression; however, if and
https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 4/10
06/11/2023, 16:24 An organizing, integrative review

how treatment of OSA improves depressive

symptoms is unclear. To further understand
this link we considered the role of emotional
regulation – the ability to control and express
our emotional responses – thought to be a
central component of depression. This study
aimed to assess changes in depressive
symptoms and emotional responses in
individuals with OSA after 4- and 12-months of
continuous positive airway pressure (CPAP)
treatment. One-hundred and twenty-one OSA
participants (50 female, Mage = 51.93; mean
AHI = 36.27) were recruited from a tertiary
clinical sleep service prior to CPAP initiation,
and randomised to either a CPAP group or a 4
month wait-list group. Participants completed
the Center for Epidemiological Studies
Depression Scale, the Emotional Reactivity
Scale and the Difficulties in Emotion
Regulation Scale at baseline, and 1-, 2-, and 4-
months follow-up. The CPAP group also
completed the questionnaires 12-months after
CPAP initiation. CPAP use at 1 month and 12
months was 5.1h/night and 4.9h/night,
respectively. Significant improvements in
depressive symptoms, emotional regulation and
reactivity, and subjective sleepiness were
observed after 4 months in both groups,
however, the within group changes were only
significant for those using CPAP. After 12-
months of CPAP treatment, these
improvements were maintained. There was no

https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 5/10
06/11/2023, 16:24 An organizing, integrative review

association between CPAP treatment adherence

and improvements in any outcome. CPAP
treatment for 12 months may reduce symptoms
of depression and improve emotional
regulation in individuals with OSA.

The issue of college student suicide has

emerged as a significant global public health
concern. To date, there has been a lack of
extensive research on the effects of distinct
forms of bullying victimization (traditional
bullying victimization and cyberbullying
victimization) on suicidal ideation, as well as
the differences between them. The present
study aimed to investigate the relationship
between two forms of bullying victimization
and suicidal ideation among female college
students, while also considering the potential
mediating effects of rumination and insomnia.

A total of 2106 female college students from

Southern China participated in this study. The
participants had a mean age of 19.83 years
(SD = 1.04 years). Participants completed the
MINI-C questionnaire, School Bullying
Behavior Questionnaire, Cyberbullying
Inventory (CBI), Ruminative Responses Scale
(RRS), and Insomnia Severity Index (ISI). The
mediation models were conducted using Model
4 and Model 6 of the Process macro program in
SPSS.

https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 6/10
06/11/2023, 16:24 An organizing, integrative review

The results showed that (1) the mediating effect

of rumination in the relationship between
different forms of bullying victimization and
suicidal ideation was significant; (2) The
mediating effect of insomnia in the relationship
between traditional bullying victimization and
suicidal ideation was not significant; the
mediating effect between cyberbullying
victimization and suicidal ideation was
significant. (3) The chain mediating effect of
rumination and insomnia in the relationship
between different forms of bullying
victimization and suicidal ideation were both
significant.

This study endeavor represents the first

attempt to investigate the relationship between
two forms of bullying victimization and suicidal
ideation.

Research suggests that genetic variants linked

to serotonin functioning moderate the
association between environmental stressors
and depressive symptoms, but examining
gene–environment interactions with single
polymorphisms limits power.

A multilocus genetic profile score (MGPS)

approach to measuring serotonergic multilocus
genetic variation and examined interactions
with interpersonal relationship, insomnia with
depressive symptoms as outcomes in an
adolescent sample (average
https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 7/10
06/11/2023, 16:24 An organizing, integrative review

age = 14.15 ± 0.63 years since first

measurement; range: 13 to 15).

(1) interpersonal relationship predicted

adolescent depressive symptoms; (2) insomnia
mediated the effect of interpersonal
relationships on adolescent depressive
symptoms; (3) the THP2 gene rs4570625
polymorphism G allele was a key risk factor for
depressive symptom, and the MGPS moderated
the effects of teacher-student relationship and
insomnia on adolescent depressive symptom.
Specifically, as the MGPS increased, the effects
of insomnia on adolescent depressive symptom
were enhanced; further, when the MGPS score
increased, the effect of teacher-student
relationship on depression showed a similar
phenomenon with an increased slope and
enhanced prediction; and (4) the results of
sensitivity analysis showed that multilocus
genetic interaction with the environment had a
better explanatory power and stability for
depression than single polymorphism studies.

MGPS provides substantial power to examine

gene–environmental interactions linked to
affective outcomes among adolescents.

Nicotine use can influence inadequate sleep,

but less is known about the associations of
exclusive and dual use of electronic cigarettes
(e-cigarettes) with combustible cigarettes in
U.S. young adults. This study assessed the
https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 8/10
06/11/2023, 16:24 An organizing, integrative review

associations between current exclusive e-

cigarette use, exclusive cigarette smoking, and
dual e-cigarette and combustible cigarette use
and inadequate sleep duration among U.S.
young adults.

We performed a secondary analysis of 2020

Behavioral Risk Factor Surveillance System
(BRFSS) data including 13,978 U.S. young
adults ages 18–24 years. Inadequate sleep
duration was assessed categorically using the
National Sleep Foundation's age-specific
recommendations that define <7 h as
inadequate sleep. Weighted logistic regression
models were performed while adjusting for
participants' sex, race/ethnicity, education
level, annual household income level, body
mass index, current physical activity, mental
health status, disability status, current alcohol
use, and current smokeless tobacco use.

Concerning use patterns, 11.8% of young adults

were exclusive e-cigarette users, 4.7% were
exclusive cigarette smokers, and 3.8% were
dual e-cigarette and combustible cigarette
users. Exclusive e-cigarette users (adjusted
odds ratio [AOR] = 1.41, 95% confidence
interval [CI] = 1.16–1.72), exclusive cigarette
smokers (AOR = 1.63, 95%CI = 1.22–2.18), and
dual product users (AOR = 2.03, 95%CI = 1.44–
2.86) were at increased odds of having
inadequate sleep duration compared to non-
users, while adjusting for the covariates.

https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 9/10
06/11/2023, 16:24 An organizing, integrative review

Additionally, dual product users were at

increased odds (AOR = 1.52, 95%CI = 1.06–
2.19) of reporting inadequate sleep duration
compared to exclusive e-cigarette users, while
adjusting for the covariates.

Current e-cigarette and cigarette use may

influence inadequate sleep among U.S. young
adults. Tobacco cessation efforts may
encourage increased sleep health.

https://www.sciencedirect.com/science/article/abs/pii/S1087079216000046 10/10